Search Results (493)

Background/Objectives: Geographic Information Systems (GIS) offer essential capabilities for identifying spatial concentrations of vulnerability and strengthening context-aware prevention strategies. This manuscript describes a geospatial architecture designed to generate anticipatory, place-based risk identification applicable across diverse community and institutional environments. Interpersonal Violence (IPV), one of several preventable harms that benefit from this spatially informed analysis, remains a critical public health challenge shaped by structural, ecological, and situational factors. Methods: The conceptual framework presented integrates de-identified surveillance data, ecological indicators, environmental and temporal dynamics into a unified spatial epidemiological model. Multilevel data layers are geocoded, spatially matched, and analyzed using clustering (e.g., Getis-Ord Gi*), spatial dependence metrics (e.g., Moran’s I), and contextual modeling to support anticipatory identification of elevated vulnerability. Framework Outputs: The model is designed to identify spatial clustering, mobility-linked risk patterns, and emerging escalation zones using neighborhood disadvantage, built-environment factors, and situational markers. Outputs are intended to support both clinical decision-making (e.g., geocoded trauma screening, and context-aware discharge planning), and community-level prevention (e.g., targeted environmental interventions and cross-sector resource coordination). Conclusions: This framework synthesizes behavioral theory, spatial epidemiology, and prevention science into an integrative architecture for coordinated public health response. As a conceptual foundation for future empirical research, it advances the development of more dynamic, spatially informed, and equity-focused prevention systems. Full article

The early diagnosis and treatment of civilizational diseases remain a significant challenge worldwide. Although advances in medical technology have led to the introduction of more screening options over time, these measures are still insufficient to effectively reduce mortality from deadly diseases such as lung cancer (LC), cardiovascular diseases (CVD), diabetes, and chronic obstructive pulmonary disease (COPD). These conditions pose a major public health burden, underlying the urgent need for more comprehensive and efficient prevention strategies. Recently, the concept of ‘multiscreening’ has emerged as a promising approach. Multiscreening involves the simultaneous screening for multiple diseases using integrated diagnostic methods, potentially improving early detection rates and optimizing resource utilization. In 2024, Rzyman W. et al. launched the MULTIPREVENT epidemiological study, which aims to develop and validate a low-dose computed tomography (LDCT)-based screening test for civilizational diseases. This study represents a step forward in the pursuit of more effective, minimally invasive diagnostic tools that could facilitate earlier intervention and improve patient outcomes. To better understand the potential of multiscreening approaches and their clinical utility, it is essential to evaluate the existing predictive models used for identifying individuals at high risk for these diseases. This narrative review focuses primarily on lung cancer risk prediction models used in LDCT screening while situating these approaches within the broader conceptual framework of the MULTIPREVENT project, aimed at future integration of multi-disease prevention strategies. With this analysis, we aim to provide insights that will guide the development of more accurate, integrative screening tools that could reduce the global burden of these diseases. Full article

Background/Objectives: This study presents a comprehensive and updated epidemiological and public health assessment of human immunodeficiency virus (HIV) in Romania during 2022–2024, situated within the wider European context. Methods: For this retrospective descriptive study, we analyzed national surveillance data from the National Institute of Infectious Diseases “Prof. Dr. Matei Balș” and European Centre for Disease Prevention and Control (ECDC) reports, between 1985–2024, focusing especially on 2022–2024 period. Key indicators included incidence, mortality, transmission routes, age and gender distribution, and treatment coverage. Comparative analyses were performed between Romania and European Union (EU)/Eastern Europe data. Results: Between 1985 and 2024, Romania registered a cumulative total of 28,793 HIV cases, with 18,768 individuals living with HIV (PLHIV) as of 2024. In that year, 810 new HIV cases were diagnoses, indicating a modest uptick compared with 2022–2023. Heterosexual transmission continued to predominate (59.4%), followed by cases among men who have sex with men (MSM) (30.5%) and intravenous drug users (IDUs) (5.2%). Men represented more than three-quarters of all new infections. Mortality displayed considerable year-to-year variability, increasing from 125 HIV-related deaths in 2023 to 193 in 2024. Despite this, treatment coverage improved steadily, with 16,464 individuals receiving antiretroviral therapy (ART) by the end of 2024. At 2.51 cases per 100,000 population, Romania’s incidence remained below the European average of 3.5 per 100,000. Nonetheless, the proportion of infections attributable to MSM transmission rose sharply—from 3.91% in 2007 to 32% in 2024—bringing Romania’s epidemiological profile increasingly in line with broader trends observed in Eastern Europe. Conclusions: These findings suggest that although Romania maintains a comparatively lower HIV incidence than the European average, the evolving transmission dynamics—most notably the substantial increase in MSM-related cases—signal a shifting epidemiological landscape that warrants strengthened, population-specific prevention measures and continued investment in comprehensive treatment and monitoring frameworks. Full article

Bacillus anthracis has three main virulence factors: an extracellular capsule and two binary toxins (lethal toxin—consists of a lethal factor and a protective antigen, and edema toxin—consists of an edema factor and a protective antigen). In the Russian Federation, the epidemiological situation regarding anthrax infection remains unfavorable. In the late stages of an anthrax infection, antibiotic therapy becomes ineffective and the patient dies within 24 h as a large amount of lethal toxin accumulates in the patient’s blood. Antibodies capable of neutralising lethal toxin (LT) can be an effective treatment for these patients. The objective of the study was to construct a chimeric monoclonal antibody targeting the protective antigen of the LT and to elucidate its mechanism of toxin neutralization. In this work, a chimeric monoclonal antibody (xi1E10) directed against the protective antigen was successfully produced. Both in vitro and in vivo experiments demonstrated the capacity of xi1E10 to neutralize lethal toxin. Confocal microscopy revealed that xi1E10 effectively suppresses the formation of a functional pore, thereby blocking the translocation of the lethal factor into the cytosol. These findings indicate that the monoclonal antibody xi1E10 represents a promising candidate for the development of a therapeutic drug. Full article

Canine parvovirus (CPV) is the primary cause of viral enteritis in dogs, while canine bocavirus (CBoV) and canine bufavirus (CBuV) have emerged as significant components of the canine enteric virome. Previous studies on CPV in Sichuan had limited geographic coverage and sample size, and lacked data on CBoV and CBuV. This study used PCR to investigate the genetic diversity of CPV, CBoV and CBuV and to examine their co-infection status in diarrheic dogs across five regions of Sichuan between 2020 and 2022. The results revealed that CPV-2 was the most prevalent virus (33.3%, 48/144), while CBoV (5.56%, 8/144) and CBuV (4.17%, 6/144) were detected for the first time in Sichuan province. Genetic analysis revealed CPV-2c to be the predominant genotype (95.8% (46/48)), replacing the previously circulating strains CPV-2a and CPV-new 2a. The study also identified several typical and novel mutations in the VP2 protein in the CPV-2c strains, including Ala5Gly, Trp214Cys and Thr440Ala. Additionally, four co-infection cases (2.78%) were observed, including a triple CPV/CBoV/CBuV infection in Xichang (XC05). Phylogenetic analysis revealed genetic diversity, with CBoV strains clustering into CBoV-1 and CBoV-2 subspecies, while CBuV strains formed two distinct clusters. Our findings emphasize the need for ongoing monitoring of the dynamic epidemiological situation of CPV, CBoV and CBuV in Sichuan Province. Full article

The epidemiological situation in Poland for IBV GII (formerly known as D1466) has seemed stable over the years, but an increase in such infections has been recently reported. In this study, genetic characterization of the representatives of this genotype was performed in order to determine whether the new epidemic wave of GII IBV was responsible for changes in this status quo. Genotyping based on the complete S1 coding region of eight Polish IBV field strains from 2011 to 2021 confirmed that they belonged to genotype II, with two of them clustered in the two previously identified GII-1 and GII-2 lineages. In turn, the S1 coding region sequences of the next six Polish strains are very different from the previous ones and form a separate group on the phylogenetic tree. However, comprehensive analysis of all complete S1 coding regions of GII strains did not fulfill all parameters needed to create the separate GII lineage, and they all seem to belong to the GII-1 lineage. Further analysis of the partial S1 sequence of 15 IBV GII strains showed their genetic distinctiveness and indicates the ongoing evolution of this virus genotype. Considering the results of our study and the recent outbreaks of GII-2 in Western Europe, it appears that infections with GII virus strains mainly affect egg-producing, long-lived chickens, commercial layers, and breeders. Furthermore, due to the high diversity of these viruses, their circulation in the poultry population may remain undetected, and for this reason, the observed production problems in laying flocks may be attributed to other, unrelated factors. Full article

Despite the economic importance of Mizuhopecten yessoensis, little is known about their parasites and immunity. This study, the first to examine the prevalence and intensity of Perkinsus across three age groups of scallops from four locations in the Sea of Japan, revealed that the gills, mantle, and digestive glands of one-year-old specimens from mariculture farms are heavily colonized. The cases of infection were notably higher in older specimens (mostly hemolymph and shell), suggesting that they act as carriers of Perkinsus. An immunological analysis indicated that when the pathogen is found only in the hemolymph and mantle, there is an increase in plasma protein concentrations, which likely plays a crucial role in resisting infection. However, when hypnospores were present in the mantle and gills, a decrease in reactive oxygen species and granulocytes occurred, accompanied by an increase in hemoblasts and agranulocytes. Phagocytic activity increased only when the pathogen appeared in the digestive gland. This evidence highlights the heightened vulnerability of young scallops, emphasizing the necessity for preventive measures against infection. The current troubling epidemiological situation regarding scallop diseases in the region suggests a rise in epizootics, raising doubts about the sustainability of the scallop farming industry unless timely interventions are implemented. Full article

People who use crack cocaine (PWUCC) constitute a key population due to vulnerability and marginalization, especially in a socio-ecologically diverse, relatively isolated region with limited public health infrastructure. This study aimed to perform a genetic characterization of circulating HCV among PWUCC in the municipality of Bragança, situated on the Brazilian Amazon coast, identifying viral genotypes, subtypes, resistance-associated substitutions (RAS)—naturally occurring mutations in the viral genome that can reduce the efficacy of direct-acting antiviral (DAA) agents—and predictions of phenotypic resistance. Methods: Between 2016 and 2018, biological samples and epidemiological data were obtained from 165 PWUCC. Viral detection was performed using RT-PCR, while genotyping, subtyping, and RAS profiling were conducted through nucleotide sequencing and fragment analysis. Results: In 165 PWUCC, 22 (13.3%) tested positive for HCV RNA. Most of them had not had access to public health services (91.5%), and more than half (57.0%) reported living in unstable housing conditions. HCV subtypes 1a (27.3%), 1b (40.9%), and 3a (31.8%) were detected. Evidence of resistance associated with DAAs, such as daclatasvir and dasabuvir, was detected in five PWUCC with HCV (22.7%). Conclusions: The high prevalence of HCV infection, predominantly subtype 1b, and significant levels of resistance are very concerning. This demonstrates the urgent need for targeted public health interventions to expand access to testing, treatment, and effective antiviral therapy in this vulnerable population of the Brazilian Amazon. Full article

Colorectal cancer (CRC) is the third most commonly diagnosed malignancy worldwide and remains a major challenge in contemporary oncology, where early detection is critical for improving treatment outcomes and survival. Despite significant progress in diagnostics and therapy, the epidemiology, risk factors, and molecular mechanisms driving CRC development continue to be intensively investigated. This paper provides an overview of current trends in CRC diagnosis and management, with particular emphasis on advances in molecular medicine and biological sciences. Screening recommendations in Poland are discussed, comparing invasive methods—such as colonoscopy, sigmoidoscopy, and CT colonography—with non-invasive stool-based tests (FOBT, FIT, sDNA-FIT), and evaluating their sensitivity, specificity, and impact on mortality reduction. Key tumor markers with diagnostic, prognostic, and predictive value, including CEA, CA19-9, mSEPT9, ctDNA, TPS, TAG-72, CTCs, and circulating microRNAs, as well as p53 and PTEN proteins, are reviewed in the context of their clinical utility in early detection, disease monitoring, and treatment response assessment. The analysis also highlights the epidemiological situation in Poland and underscores the growing importance of integrating molecular biomarkers with traditional diagnostic methods, which may ultimately support the development of more precise and individualized clinical management strategies in the future. Full article

Bovine viral diarrhea virus (BVDV) poses a serious disease in cattle. Cachexia is a condition marked by weight loss and muscle wasting and is often observed in infected animals. This study reports a case series from Tiaret province, Algeria, aimed at detecting and genetically identifying BVDV in clinically cachectic cattle. A total of 100 cachectic animals from ten herds were examined using serological, molecular, and virological methods, including antibody ELISA, RT-qPCR, and virus isolation in cell culture. Overall, 93.6% of the animals tested were seropositive for BVDV, indicating extensive exposure to the sampled population. Higher antibody rates were observed in adults (≥12 months) and males compared to younger animals and females, but the differences were not statistically significant. Phylogenetic analysis of the 5′UTR sequences confirmed the presence of the BVDV-1f subtype closely related to sequences reported in Europe. Although BVDV was detected in animals within the sampled herds, the data does not support a causal conclusion that BVDV was the direct cause of cachexia in this case series; rather, its immunosuppressive effects may predispose cattle to secondary infections contributing to wasting. These results are specific to this opportunistic case series from Tiaret province and should be considered exploratory; broader and representative surveillance is required to assess the national epidemiological situation. Full article

Carbapenem-resistant Klebsiella pneumoniae isolates harbouring double carbapenemases, from patients in a surgical and transplantation ICU, were investigated to better understand the dispersion of the pathogen. Twenty-three carbapenem-resistant K. pneumoniae isolates harbouring at least two different carbapenemases (by immunochromatography screening), were consecutively collected during a seven-month period from patients in a surgical and transplantation ICU. Identification and susceptibility testing were performed using the MALDI-TOF Vitek MS and the Vitek2 system (BioMerieux), respectively. Whole genome sequencing (WGS) was performed in an Illumina NextSeq2000 platform and MLST and resistome analysis of assembled genomes were performed by ResFinder, through the Center for Genomic Epidemiology platform. All isolates were resistant to ertapenem, imipenem, meropenem, and most to meropenem–varbobactam. Seventeen isolates belonged to the ST11 type and were positive for the OXA-48/NDM combination (by immunochromatography and NGS). Four isolates belonged to the ST39 type and were positive for the KPC/NDM combination (by immunochromatography and NGS). Finally, two isolates belonged to the ST258 type. One of them was positive for the OXA-48/KPC/NDM combination (by immunochromatography), but only bla_KPC was detected by WGS, and the second was positive for the OXA-48/KPC combination (by immunochromatography) and confirmed by WGS. This is the first report of an outbreak in Greece due to two simultaneous carbapenem-resistant populations harbouring double carbapenemases: a larger one comprising ST11 isolates harbouring the combination bla_NDM-1/bla_OXA-48, coupled by a smaller one comprising ST39 isolates harbouring the combination bla_KPC-2/bla_NDM-1. The implications of this particular situation regarding public health as well as intra-nosocomial infection prevention and control should be further monitored and studied. Full article

Background: Central nervous system (CNS) tumors during pregnancy are rare but present significant diagnostic, therapeutic, and ethical challenges. These include both primary and metastatic lesions, which share overlapping clinical features and management complexities. Their clinical course is influenced by gestational physiological changes, which can mask symptoms and delay diagnosis, thereby increasing maternal and fetal risks. Objective: This review aims to synthesize current evidence on the epidemiology, pathophysiology, clinical presentation, diagnostic strategies, treatment options, prognosis, and ethical considerations related to CNS tumors in pregnant patients. Methods: A comprehensive literature review was conducted, including retrospective and prospective studies, clinical guidelines, and systematic reviews focusing on brain and spinal tumors diagnosed during pregnancy. Particular attention was given to the impact of gestational age, tumor histology, and maternal condition on treatment outcomes. Results: Hormone-sensitive tumors such as meningiomas and prolactinomas may exhibit accelerated growth during pregnancy due to elevated progesterone and prolactin levels. Diagnosis is often delayed due to symptom overlap with normal gestational changes. MRI without contrast remains the imaging modality of choice. Glucocorticoids and selected chemotherapy agents can be cautiously used depending on gestational age. Surgical resection, particularly in the second trimester, has been shown to be safe and effective in appropriate clinical scenarios. Multidisciplinary coordination is essential. Prognosis varies based on tumor type and timing of intervention, with maternal survival prioritized in high-risk situations. Ethical management hinges on patient autonomy, informed consent, and proportionality of medical interventions. Conclusions: CNS tumors during pregnancy require early recognition, individualized treatment planning, and ethical vigilance. Multidisciplinary collaboration is vital to optimizing outcomes for both mother and fetus. Future efforts should focus on developing standardized protocols and expanding evidence through multicenter studies. Full article

Background: Healthcare-associated infections (HAIs) are a significant public health problem, having a decisive impact on the prognosis of patients hospitalized with COVID-19. In Romania, the absence of a uniform reporting system and the lack of epidemiological data comparable to European standards limit the real assessment of their incidence and consequences. Methods: In this context, the present study aimed to conduct an integrated analysis of the clinical, epidemiological, and microbiological factors involved in the mortality of patients with COVID-19 and HAIs in a county located in southeastern Romania. This research was based on a retrospective observational study that included 295 patients with a confirmed diagnosis of COVID-19 and at least one documented HAI between January 2020 and December 2022. Data were extracted from standardized reporting forms, and statistical analyses included tests (Fisher’s exact test, Mann–Whitney U), ROC curves, Kaplan–Meier survival analysis, and Cox proportional hazard regression. Results: The analysis revealed a mortality rate of 32.5%, significantly associated with advanced age, gastrointestinal surgery, and respiratory infections. Clostridioides difficile was the predominant pathogen (84.1%), and the threshold of ≥63.5 years demonstrated predictive value for mortality. In multivariate models, age greater than 63 years and gastrointestinal surgery were confirmed as independent predictors of death. Conclusions: The findings highlight the substantial impact of HAIs on the clinical progression of COVID-19 patients, underscoring the need for comprehensive systemic interventions, including enhanced prevention and control strategies, prudent antimicrobial therapy, and standardized epidemiological monitoring. Implementing these measures is crucial to mitigating HAIs’ effects and improving patient outcomes in similar situations. Full article

Zika virus (ZIKV) was first identified in Africa in the mid-20th century and circulated for decades with limited and often unnoticed human cases. This situation changed with the emergence of the Asian lineage, responsible for large outbreaks in the Pacific and the Americas and for severe complications such as Guillain–Barré syndrome and Congenital Zika Syndrome (CZS). In contrast, the African lineage, although frequently more efficient in replication, cytopathogenicity, and mosquito transmission in experimental systems, has not been linked to comparable epidemics or congenital disease clusters. This review summarizes current knowledge on the differences between African and Asian lineages at the molecular, cellular, and epidemiological levels. It highlights how genetic variation interacts with host immunity, ecological factors, and human activity to shape epidemic potential. Understanding these interactions is essential for anticipating future outbreaks and for improving strategies to mitigate the impact of emerging arboviruses. Full article

Introduction: Antimicrobial resistance constitutes one of the key challenges to public health. It is a particularly serious problem in the context of hospital-acquired infections (HAIs). By causing infections that are difficult to treat, multiple-drug-resistant bacteria in the hospital environment often require the use of toxic and costly drugs and prolonged hospital stays, and they result in long-term health consequences for patients, including a high risk of death. This study aimed to assess the epidemiological situation of antibiotic-resistant microorganisms in patients hospitalised at the University Teaching Hospital in Bialystok, Poland, between 2020 and 2023. Methods: Data from epidemiological reports covering 15 alert pathogens, including MRSA, VRE, KPC (+), and ESBL (+), were analysed. Their prevalence was assessed in three groups of wards: intensive care, surgical, and non-surgical. Infection and microbiological testing rates were referenced to the number of hospitalisations and patient-days. Results: A total of 6066 cases of infections caused by resistant microorganisms were identified. The most frequently isolated pathogen was Enterococcus faecium VRE, peaking in 2022 (11.43 per 1000 patients). A marked increase in Klebsiella spp. KPC (+) and Enterobacter spp. ESBL (+) was observed, particularly in the 2021–2022 period. Intensive care units showed the highest infection rate (30–36 per 1000 patient-days). In the 2022–2023 period, infections detected within <72 h of admission predominated, which may indicate prior patient colonisation or intensified screening. Conclusions: The rise in infections caused by antibiotic-resistant bacteria requires a high level of microbiological surveillance to be maintained, especially in intensive care units, and preventive measures at hospital admission to be strengthened. Full article